At CureMD Private Limited, I manage denied and underpaid claims for out-of-network, non-PAR provider accounts. I identify denial root causes and pursue accurate reimbursement through first- and second-level appeals.
I review EOBs and ERAs, investigate eligibility, authorization, timely filing, medical necessity, and coding denials, and coordinate directly with commercial insurance payers. I document claim activity carefully while meeting productivity, quality, payer-guideline, and client requirements.
I work with CPT, ICD-10-CM, and HCPCS codes, along with CureCAM, Codify, EHR/PM systems, eligibility portals, and spreadsheets to support claim review and appeal preparation.
Previously, I handled inbound and outbound corporate customer-service calls, resolving inquiries and service requests through professional communication and customer management.
